FORM 1023-EZ for THRIVING ELEMENTS

Field Data
EIN 81-1942546
Case Number EO-2019129-000395
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THRIVING ELEMENTS
Organization’s Mailing Address 2122 N 112TH STREET APT A
City SEATTLE
State WA
ZIP 98133
Accounting period End 6
Primary contact name JANET T PHAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANET T PHAN
FOUNDER & EXECUTIVE DIRECTOR
2122 N 112TH ST APT A
SEATTLE WA 98133

Officer/Director/Trustee Two

KELLY HOEFT
CURRICULUM DIRECTOR
2805 NE 125TH STREET UNIT 407
SEATTLE WA 98125

Officer/Director/Trustee Three

JOSEPH PECK
BOARD MEMBER
2805 NE 125TH STREET UNIT 407
SEATTLE WA 98125

Officer/Director/Trustee Four

LUKE BAILEY
BOARD MEMBER
16032 SIMONDS ROAD NE
KENMORE WA 98028

Officer/Director/Trustee Five

SUNG LEE
BOARD MEMBER
17321 MURPHY AVE APT 218
IRVINE CA 92614

Organization’s website WWW.THRIVINGELEMENTS.ORG
Organization’s email MENTORING@THRIVINGELEMENTS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/12/16
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JANET T PHAN
Signature Title FOUNDER & EXECUTIVE DIRECTOR
Signature Date 5/8/19

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